B.C. VIEWS: Time to listen to the doctors and legalize opioid drugs

As the B.C. Coroners Service released its 2018 overdose-related death totals, showing four people a day are still dying from mainly fentanyl-contaminated street drugs, there was a desperate edge to the message.

Dr. Bonnie Henry, the provincial health officer, pleaded with politicians to take action beyond handing out overdose kits and declaring emergencies. In short, prohibition is pushing users onto the street, and the flow of smuggled fentanyl, mainly from China, hasn’t slowed despite frantic efforts to harden North America’s borders to it.

The grim update was provided by B.C. Chief Coroner Lisa Lapointe, Henry and Dr. Evan Wood, executive director of the B.C. Centre for Substance Use. People who follow this story will know that paramedics, nurses and doctors are run ragged, mostly reviving hardcore street users with Naloxone injections, sometimes multiple times in the same day.

Meanwhile, people continue to die at home, alone. The vast majority are men between the ages of 30 and 59. They’re not classic junkies, and as a member of that demographic I would suggest that most of them hold down jobs rather than descending to stealing or selling their bodies to get the next fix.

Wood reluctantly calls them “weekend warriors.” Another interesting stat is that the majority of them are buying stimulants, mostly cocaine or methamphetamine, that turns out to be contaminated with fentanyl. More on that in a minute.

The message to politicians was clear. Henry noted that federal law criminalizing narcotic possession is the main obstacle to progress, and that prescription substitutes such as diacetylmorphine have shown significant results in the limited tests Ottawa has allowed.

“That’s what my office is working on … how we can have de facto decriminalization of people who use drugs in B.C., recognizing that is one of the huge challenges that is leading to people using street drugs and dying, and using alone,” Henry said.

Wood said public education is needed “so the winds start to blow in a direction where the politicians see where they can really act freely and start applying some of the public health models.”

Henry said B.C. is studying Portugal’s prescription model, which is held up as an international success. In 2001, drug laws there were amended to keep hard drugs illegal, except for authorized personal use. Anyone caught with up to 10 days’ unauthorized supply is subject to an administrative penalty rather than facing jail time for possession of heroin, cocaine or the synthetic variants now cranked out by organized crime.

Coroner Lapointe referred to a survey of B.C. users that found almost half claimed they were looking for pain relief. Given the option of “pain-related,” that’s what they told surveyors.

“Pain-related wasn’t defined,” Lapointe said. “Was that physical pain, was that emotional pain, was that psychological pain? But people are reaching out for help.”

This is where I beg to differ with the soothing message of the medical establishment. People aren’t scoring tainted coke or meth because their knees are sore, or their divorce was unpleasant. They’re doing it because decades of popular culture have taught them that getting high and partying are the main reasons to go to work.

Prohibition didn’t work for booze, it didn’t work for marijuana, and it won’t work for “ecstasy” or heroin either. Fentanyl, a needed painkiller for people dealing with cancer or major surgery, might just open the eyes of timid politicians to the need to act.